An increasing number of people under the age of 40 are developing mouth cancer. Alison Lowe, a Cardiff-based dental hygienist, looks at the reasons behind this worrying trend

WE ARE in the midst of Mouth Cancer Action Month, an annual campaign launched by the British Dental Health Foundation to raise awareness about this debilitating illness.

Many campaigns of this type boast of significantly improved survival rates and visionary treatments, but mouth cancer is sadly bucking the trend.

Statistics point to a 40% increase in the number of newly diagnosed cases across the UK over the lpast decade and it is said to claim more than 2,000 lives each year.

Furthermore, mouth cancer survival rates have shown very little improvement over the past 20 years –the five-year survival rate is just 50%.

A diagnosis of mouth cancer and the associated impact of its management have enormous implications on day-to-day activities of life such as eating, drinking, talking, socialising and working.

Indeed, it remains one of the most disfiguring and debilitating of all malignancies.

Not only that, but it is the fastest growing cancer in the UK and it kills more people than testicular and cervical cancer combined.

You could be forgiven for thinking that those most affected are old men with nicotine-stained fingers from all the cigarettes they’ve smoked.

While that might have been the case at one time, this disease knows no limits and it is being detected in an increasing number of women and young people.

Indeed, 50 years ago mouth cancer was five times more common in men than women – now it’s only twice as common and an increasing number of people under the age of 40 are developing the condition.

Given that smoking is on the decline, this is somewhat surprising.

The smoking ban in public places in the UK has gone some way to influencing a reduction in smoking and the recent ban on the sale of tobacco products in England, hopefully to be followed by legislation in Wales, will make it more difficult for young people to access tobacco.

Nonetheless, around a fifth of the UK’s population still smoke and the habit is still considered to be the leading cause of mouth cancer.

According to the World Health Organisation, up to half of smokers will eventually die of a tobacco-related disease, including mouth cancer.

So, what’s going on?

Well, growing alcohol consumption has been pinpointed as a major factor – exceeding the recommended limits can more than treble the risk of mouth cancer.

Unfortunately, alcohol also aids the absorption of tobacco into the mouth, so those who smoke and drink to excess are up to 30 times more likely to develop the disease.

They say that there is no smoke without fire, but it is a misconception that smokeless tobacco is safer than smoking – the reality is that it’s much more dangerous.

The Human Papilloma Virus (HPV) has had a huge impact.

It can be sexually transmitted and is found in the mouth and throat.

It is an oncovirus, meaning that it could potentially lead to cancer.

The incidence of HPV-related mouth cancer is increasing, particularly from HPV strains 16 and 18.

Indeed, approximately 74% of HPV positive cancers are found on the tonsils.

Experts suggest that it may rival alcohol and tobacco as a major cause of mouth cancer within 10 years.

Younger people are particularly at risk and those with multiple sexual partners even more so.

Recent research also suggests that certain strains of the herpes virus and some species of candida could have a role in the development of mouth cancer.

It is early days yet and more studies are needed, but there is evidence to suggest that xylitol can help to reduce some of the harmful effects of candida – watch this space.

Poor diet is another lifestyle factor. Indeed up to a third of cases can be attributed to this.

The good news is that various studies have shown that women with high folic acid intake are at lower risk from mouth cancer and that an increase in high-fibre foods and omega 3 can help decrease the possibility.

We should also aim to eat more vegetables from the cruciferous family, including cauliflower, broccoli, sprouts and cabbage.

Most dental teams are on the ball when it comes to detecting mouth cancer and their early intervention and screening is vital in saving lives.

However, there are calls from health experts for better on-going training for the dental team to recognise the warning signs and take action sooner.

To this end, the General Dental Council has confirmed that improving early detection is to be included as a recommended topic in its Continuing Professional Development scheme.

This is essential, as early diag-nosis gives patients a 90% chance of survival.

Cancers of the lip, tongue and throat all come under the mouth cancer umbrella and the BDHF are urging people to have a little look at the insides of their mouth.

If you find anything unusual it is worth visiting your dentist.

Possible signs to look out for include:

An ulcer in the mouth that has not healed;

a white or red patch in the mouth that doesn’t go away;

a lump or thickening on the lip or in the mouth and/or throat;

difficulty or pain with chewing and swallowing;

loose teeth for no apparent reason, and

a lump in the neck.

It is really important to remember that the disease is potentially curable if caught early enough.